INTRODUCTION TO CLINICAL MEDICINE
8TH EDITION
AUTHOR(S)GARY D. HAMMER; STEPHEN J.
MCPHEE
TEST BANK
1.
Reference
Ch. 1 — Introduction
Question Stem
A 56-year-old man presents with progressive dyspnea and a 20-
pack-year smoking history. You must decide whether his
presentation represents disease, risk factor, or a physiologic
adaptation. Which statement best applies to distinguishing
disease from adaptation in clinical reasoning?
Options
A. A physiologic adaptation is always reversible; a disease
process is always irreversible.
B. Disease implies structural or functional disturbance that
,impairs normal homeostasis; adaptation preserves function
despite stress.
C. Risk factors are interchangeable with disease when they
cause symptoms.
D. Any laboratory abnormality indicates disease even without
symptoms.
Correct Answer
B
Rationales
Correct: Hammer & McPhee define disease as a structural or
functional disturbance that impairs normal homeostasis;
adaptations (e.g., hypertrophy) are cellular responses aiming to
preserve function under stress.
A: Not correct — some adaptations can be reversible but some
early disease states are reversible as well; irreversibility is not
the defining distinction.
C: Not correct — risk factors increase probability of disease but
are not the same as disease.
D: Not correct — abnormal tests must be interpreted in clinical
context; laboratory change alone does not necessarily mean
disease.
Teaching Point
Disease = structural/functional disturbance; adaptation aims to
preserve homeostasis.
,Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2.
Reference
Ch. 1 — Introduction
Question Stem
A nurse is interpreting a patient’s risk profile. According to
pathophysiologic principles, which approach best prioritizes
interventions to reduce disease incidence at the population
level?
Options
A. Focus solely on treating symptomatic disease after diagnosis.
B. Target modifiable risk factors to shift the population
distribution of disease risk.
C. Screen everyone with advanced diagnostic imaging
regardless of risk.
D. Emphasize genetic testing for all individuals to predict
disease.
Correct Answer
B
Rationales
Correct: Hammer & McPhee emphasize prevention by
modifying exposures (smoking, diet) that shift population risk
, and reduce incidence.
A: Not correct — treating only symptomatic disease misses
prevention opportunities.
C: Not correct — indiscriminate screening risks overdiagnosis
and resource misuse; screening should be risk-based.
D: Not correct — genetic testing is valuable when indicated, but
universal genetic testing is not currently an effective
population-level prevention strategy.
Teaching Point
Primary prevention targets modifiable risk factors to lower
population disease burden.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3.
Reference
Ch. 1 — Introduction
Question Stem
A patient’s lab shows an isolated low serum albumin without
edema or other signs. Using clinical-pathologic correlation,
what is the best next step to determine if this represents
disease?
Options
A. Immediately diagnose chronic liver disease because albumin